There was almost one hundred years since surgical stapler invention to now. Using stapler (stitching instrument) in surgery has many advantages, such as stitching fast, easy to operating, few side effects and complications. It makes tumor excision surgery can’t be cut focus in past possible and improving the curative effect of the surgery. Surgical staplers also give difficult surgery and new technology strong supports. In the last ten years, for cheap price and rapid development of the technology level, domestic staplers’ market share is increasing year by year and breaking the foreign monopoly product. In open surgery, domestic stapler has progressively more than foreign brands. In endoscopy surgery, domestic staplers also have a place. In current, surgical staplers are used more and more popular in the domestic tertiary medical institutions and becoming indispensable tools in many surgeries. Surgical staplers (stitching instrument) are broadly used in esophageal reconstruction, gastrointestinal tract reconstruction, endoscopic surgery in pulmonary bulla resection, uterus resection, pancreas resection, duodenum resection

Objective To study the method and effect of exposure the recurrent laryngeal nerve(RLN) in preventing the damage of RLN in thyroid surgery. Methods One thousand and ten sides total and(or) subtotal thyroidectomies were operated on 574 cases with RLN exposure in our hospital in recent 9 years. Results The RLN injury rate was 0.3% in this series.Of them, permanent RLN injury occurred in 2 cases and temporary injury in 1. Conclusions The exposure of RLN can greatly decrease the nerve injure in thyroid surgery, especially in total lobectomy. The dissection of RLN must followed the principle of RLN exposure . RLN should be dissected around the inferior thyroid artery first, if the RLN is difficult to be found,then dissecting around the thyroid cartilage, or finding the cervical vagus inside of carotid sheath to find RLN should be done.

To meet the requirements for the development of marine resources and military operations, divers usually dive deeper than the depth at which narcosis is present during air diving.Under this condition, heliox is required for this div-ing.Sofar, some countries have developed their own decompression tables for routine heliox diving.The best-known is tables from USA and France.In the preceding century, tables of Former Soviet Union and France used for routine heliox diving were introduced into China.On the basis of both types of tables,Chinese Navy developed their own tables for this purpose. In this paper, we summarized the characteristics of these tables from 5 countries and compared them in terms of structure, oxygen use, total decompression time, first stop and other features.This may provide a basis for future modification of ta-bles used in China and the development of new tables for routine heliox diving.

Objective It is necessary for nursing staff members to assign priorities in health education to hospitalized patients to ensure curative effect .The purose of the study was to explore the effect of process management application in health education path -way to patients with rheumatoid arthritis ( RA) . Methods A total of 70 patients with rheumatoid arthritis were randomly divided into observation group and control group , 35 patients in each group .Traditional health education was done in control group , while health education pathway was performed in observation in observation group according to process management .A study of patients′satisfaction with hospitalization , compliance of medication and knowledge of health education was undertaken . Results Observation group had priority to control group in satisfaction with hospitalization and medication compliance (77.1% vs 42.9%,P <0.05; 80.0% vs 57.1%,P<0.05).As to knowledge of health education , observation group was prior to control group in dietary restrictions , functional training methods and return visit conditions (71.4% vs 40.0%;37.1% vs 14.3%;45.7% vs 17.1%).Howerver, no significant difference was found in congintion of drugs among the two groups (P>0.05). Conclusion Compared with traditional health educa-tion, the process management application of RA health education pathway helps to improve patients ′health konwledge and medical compliance , which is an effective adjuvant treatment .

Objective: To improve the traditional preparation procedure of effervescent tablets in order to raise stabilization. Methods: The orthogonal design was used for improvement of process. Results: The optimum procedure condition was A 3B 2C 1. That is adding 7.5% citric acid, 11.25% sodium bicarbonate encapsulated by 5% PEG. Conclusion: The new procedure is superior to the traditional procedure, and it is suitable for the requirement of production on a large scale.

Objective To investigate the efficacy and safety of long-term intermittent treatment with topical corticosteroids in localized chronic eczema.Methods A total of 129 patients with localized chronic eczema were treated with triamcinolone acetonide and econazole nitrate cream (Pevisone (R)).Those who achieved a clinical cure within 4-week treatment were recruited into the following long-term study and classifled into 2 groups to be intermittently treated with triamcinolone acetonide and econazole nitrate cream or a moisturizing cream for 8 weeks.The cream was applied topically twice a day for 2 days every week.Patients were followed up on week 4 and 8 after the beginning of treatment and on week 12 after the discontinuation of treatment.The severity of eczema in patients was rated according to SCORAD (SCORing atopic dermatitis) score.Results The SCORAD score was significantly lower in patients treated with triamcinolone acetonide and econazole nitrate cream than in those with moisturizing cream on week 8 in the treatment and week 12 after the discontinuation (t=3.076,2.367,both P<0.05).A statistical decrease was also observed in the recurrence rate of eczema in patients treated with triamcinolone acetonide and econazole nitrate cream compared with moisturizing cream.treated patients at the 3 follow-up time points (x2=4.426,7.683,8.199,all P<0.05).The incidence of adverse events was 3.1% during the treatment with triamcinolone acetonide and econazole nitrate cream.No severe adverse reactions were observed.Conclusion Long-term intermittent treatment with topical corticosteroids is effective for the prevention of exacerbation and postponement of recurrence,of eczema.

Objective To investigate the effect of xenotransplantation of microencapsulated rabbit parathyroid tissue in different sites in rats for the treatment of hypoparathyroidism. Methods The parathyroid glands from Wistar rats were removed to make them aparathyroid. Ultimately, sixteen rats were included because their serum calcium values were continuously below 1.6 mmol/L. We also encapsulated the cultured rabbit parathyroid tissue with alginate-BaCl2 microcapsule. According to the transplantation sites, rats were randomly divided into two groups: renal adipose microcapsule group and peritoneal microcapsule group, eight in each group. Encapsulated rabbit parathyroid tissues were then transplanted accordingly to different microcapsule groups. The calcium serum contents were examined on 5,15,25,35,45,55 and 65 d respectively after transplantation and the grafts were observed through electron microscope on the 65 d in particular. Results The calcium contents after transplantation in renal adipose microcapsule group restored to normal and the observation outcomes of grafts showed that they survived well. The calcium contents of posttransplantation in peritoneal group also restored to normal with an exception that it dropped to a level lower than 1.6 mmol/L on the 65 d. Electron microscope also showed that there were necrotic tissues in the center and only a few cells survived on the edge of the grafts. Within peritoneal microcapsule group, the values were significantly lower than others taken at different phases. Conclusion Microencapsulated rabbit parathyroid tissue that was xenotransplanted into rats can survive and function without administration of immunodepressant. There are significant differences of calcium contents at varying phases between two transplantation sites, which demonstrate that renal adipose may be an optimal site for microcapsule xenotransplantation.

Objective To study the methods and benefits of exposure of recurrent laryngeal nerve(RLN) in thyroid surgery Methods In this study, 2148 patients admitted in our hospital from July 1993 to July 2003 were divided randomly into two groups: RLN exposure group (936 cases) and RLN non exposure group (1212 cases) RLN was dissected around the inferior thyroid artery, thyroid cartilage, and cervical vagus Results Two cases (0 21%) suffered from RLN injury in exposure group and 5 cases (0 41%) suffered from RLN injury in non exposure group ( P

Objective To assess the environmental contact allergens in patients with allergic contact dermatitis (ACD).Methods Totally,167 patients with ACD were included in this study.All the patients underwent patch test.Results Of these patients,92 (55.1％) were diagnosed as facial ACD,and 148 showed positive patch test results (88.6％).The six most common allergens in a decreasing order were nickel sulfate,fragrance mix,paraphenylenediamine,thimerosal,octanoates and amerchol L 101.Conclusion Patch test may be an efficient way to confirm the cause of ACD.

Objective To analyze the results of surgical treatment on chronic pancreatitis(CP),and investigate how to choose the appropriate surgical procedure.Methods The clinical data of 54 patients with chronic pancreatitis who underwent surgery at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.Results All the 54 patients underwent surgery,including 8 decompression and drainage procedure (Partington procedure) ; 13 resections (7 cases of pancreaticoduodenectomy,1 case of distal pancreatectomy,4 cases of distal pancreatectomy combined with splenectomy and 1 case of pancreaticoduodenectomy combined with distal pancreatectomy,respectively); 12hybrids (7 cases of Beger procedure and 5 cases of Frey procedure,respectively) and 21 other procedures (15 cases of pancreatic pseudocyst jejunostomy,4 cases of exploratory laparotomy combined with pancreatic tissue biopsy,2 cases of gastrojejunostomy combined with choledochojejunostomy,respectively).There were 4 cases of post-operative pathologic evidence of cancer.Twelve patients had postoperative complications and were cured with non-operative management.Forty-four patients (81.5％) were followed for 2 to 67 months,36 out of 42(85.7％) patients who suffered from abdominal pain had a persistent remission,there were one case of new on-set diabetes and no steatorrhea was reported.Conclusions For CP patients with surgical indications,the choice of procedure should be individualized for the purpose of preserving the endocrine and exocrine functions of pancreas,and taking effectiveness as well as safety into consideration.